Foreign body ingestion in adults: a retrospective cohort study of clinical characteristics and Endoscopic outcomes

Foreign body ingestion (FBI) in adults represents a clinically relevant emergency requiring endoscopic management in selected cases. Predictors of procedural complications remain incompletely defined, particularly regarding the incremental effect of endoscopic timing. We retrospectively analyzed adults (≥ 18 years) who underwent endoscopic intervention for confirmed esophageal or gastric foreign bodies between January 2020 and January 2025. Continuous predictors were used in multivariable logistic regression to avoid information loss from arbitrary categorization. Ridge-penalized regression and bootstrap internal validation (1000 resamples) were performed to address potential small-sample bias. Model performance was assessed using the area under the receiver operating characteristic curve (AUC). A total of 122 patients were included (median age 49 years, IQR 33–65; 54.9% female). In the multivariable continuous model, endoscopy timing was independently associated with procedural complications (OR 1.12 per hour delay, 95% CI 1.01–1.24; p = 0.037), corresponding to a clinically meaningful incremental increase in complication risk. Hematemesis demonstrated a large point estimate but did not remain a stable predictor after penalized regression. Apparent model discrimination was acceptable (AUC 0.74), with moderate discrimination after optimism correction (bootstrap-corrected AUC 0.66). In adult foreign body ingestion, delay to endoscopy appears to exert a cumulative and clinically meaningful effect on complication risk. Penalized and internally validated analyses suggest that procedural timing, rather than object morphology alone, is the most consistent determinant of adverse outcomes.